Download Factor Overlap Crosswalk - Health Management Associates

Florida- Illinois CHIPRA Quality Demonstration Grant
NCQA RECOGNITION FACILITATION PROJECT
NCQA PCMH Recognition 2014 Factor Overlap Crosswalk
Element
Cross Reference
Note
PCMH 1B F3-Providing
continuity of medical record
information for care and
advice when office is closed
PCMH 1C F5-Patients
have two-way
communication with the
practice
If the practice responds “NA” on 1B
F3, they must respond “No” to 1C
F5
PCMH 2C F1-Assessing the
diversity of its population
PCMH 3A-Patient
Information
Patient race and ethnicity are
tracked in PCMH 3A
PCMH 2D –The Practice
Team
PCMH 6A-Measure
Clinical Quality
Performance
PCMH 6B-Measure
Resource Use and Care
Coordination
PCMH 6C-Measure
Patient/Family
Experience
When training and assigning roles to
care team members, the practice
references ongoing measurement
activities chosen in PCMH 6A-C. For
example, a team member could
lead an effort to conduct outreach
and provide updated immunizations
to a specific population, which the
practice measures in PCMH 6A F1
PCMH 3C- Comprehensive
Health Assessment
PCMH 4A- Identify
Patients for Care
Management
The practice should consider how its
comprehensive health assessment
helps establish criteria and supports
a systematic process for identifying
patients for care management in
PCMH 4A.
PCMH 3C- Comprehensive
Health Assessment
PCMH 4B-Care Planning
and Self-Care Support,
PCMH 4C-Medication
Management
Review the patient records for the
medical record review as required
in Elements 4B and 4C and
document presence or absence of
the information in the Record
Review Workbook. F8, 9: In
addition to the report described
above, the practice must provide a
completed from (de-identified for
each factor
PCMH 3C F3-Communication
Needs
PCMH 3A F5-Preferred
language
PCMH 3C F3 does not address
language, see PCMH 3A F5.
PCMH 3E-Implement
Evidence-Based Decision
Support
PCMH 3B-Clinical Data
Clinical data collected in PCMH 3B
supports the practice’s approach to
meeting criteria in PCMH 3E
PCMH 4A-Identify Patients
for Care Management
PCMH 4B-Care Planning
and Self-Care Support,
PCMH 4C-Medication
Management
Patients identified in 4A will be used
to draw a sample for the medical
record review required in PCMH 4B,
4C
Documentation Tools
Record Review
Workbook
1
Florida- Illinois CHIPRA Quality Demonstration Grant
NCQA RECOGNITION FACILITATION PROJECT
NCQA PCMH Recognition 2014 Factor Overlap Crosswalk
Element
Cross Reference
Note
Documentation Tools
PCMH 4C F4-Assesses
PCMH 3C F10understanding of
Assessment of health
medications for more than
literacy
50% of
patients/families/caregivers,
and dates the assessment
The practice assesses how well
patients understand the
information about medications they
are taking, and considers a patient’s
health literacy (PCMH 3C, F10)
Record Review
Workbook
PCMH 4E F2- Provides
education materials and
resources to patients
PCMH 3A-Patient
Information
Materials in languages other than
English are available for
patients/families, if appropriate,
based on the practice’s assessment
of languages spoken by its patients
(PCMH 3A). The practice may refer
patients/families to outside
resources, even if resources may
not be covered by health insurance.
PCMH 4E F6-Maintains a
current resources list on five
topics or key community
service areas of importance
to the patient population
including services offered
outside the practice and its
affiliates
PCMH 4A- Identify
Patients for Care
Management
The resource list is specific to the
needs of the practice’s population—
not necessarily specific to criteria
and areas of focus a practices uses
to identify patients likely to benefit
from care management (PCMH 4A)
PCMH 6B F1- At least two
measures related to care
coordination
PCMH 5B-Referral
Tracking and Follow-Up
Measuring adherence to
agreements (PCMH 5B) may be
used to meet the factor.
PCMH 6D-Implement
Continuous Quality
Improvement
PCMH 6A-Measure
Clinical Quality
Performance
PCMH 6B-Measure
Resource Use and Care
Coordination
PCMH 6C-Measure
Patient/Family
Experience
PCMH 6D, F 1-6 use measures
identified in PCMH 6A-C
PCMH Quality
Measurement and
Improvement
Worksheet
PCMH 6E F1-Measuring the
effectiveness of the actions
it takes to improve the
measures selected in
Element D
PCMH 6D- Implement
Continuous Quality
Improvement
In F1, the practice identifies the
steps it has taken in PCMH 6D and
evaluates these steps to improve
performance. The practice is not
required to demonstrate
improvement in this factor
PCMH Quality
Measurement and
Improvement
Worksheet
2
Florida- Illinois CHIPRA Quality Demonstration Grant
NCQA RECOGNITION FACILITATION PROJECT
NCQA PCMH Recognition 2014 Factor Overlap Crosswalk
Element
Cross Reference
Note
PCMH 6F- Report
Performance
PCMH 6A-Measure
Clinical Quality
Performance
PCMH 6B-Measure
Resource Use and Care
Coordination
PCMH 6C-Measure
Patient/Family
Experience
For each factor, the practice must
report performance data using at
least one measure from each of
Elements A, B and C. Practices are
not required to report all measures
from each to meet requirement
Documentation Tools
3